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Massachusetts Department of Public Health Proposes to Ease Moratorium on New Nursing Home Beds in the Commonwealth

The Determination of Need Program (certificate of need in other states) of the Massachusetts Department of Public Health (DON Program) has for many years had a moratorium on accepting and reviewing applications for construction that would add new nursing home beds to the healthcare system.

It is, therefore, significant that the DON Program issued a Memorandum on October 6, 2020 setting out proposed guidelines for review of determination of need applications to either add beds to an existing nursing home or construct a new nursing home.

Applicants filing for new beds would be required to meet the Memorandum guidelines in addition to the existing application review standards found in the Code of Massachusetts Regulations, 105 CMR 100.210.

The Guidelines

An applicant for new nursing home beds must show that it will do at least one of the following:

  • Demonstrate ability to treat substance abuse and mental health disorders in a long-term care setting, including the ability to provide treatment medications for opioid use disorder and psychiatric treatment/medications;
  • Reduce the risk of homelessness by improving housing stability;
  • Address unmet cultural or linguistic needs of a population; or
  • Offer treatment for specialized populations, including, but not limited to, residents with COVID-19.

In addition to targeting the needs of a specific population, an applicant must ensure that enhanced infection control measures will be used in the expanded or newly constructed nursing home and that a portion of the new bed capacity will be reserved for individuals whose care is paid by MassHealth (the state Medicaid program) or another state agency.

Applicants also must have a favorable compliance profile on the state Nursing Home Survey Performance Tool or the CMS Nursing Home Compare Rating System. Rest home operators must have met certain standards on recent annual surveys.

Finally, applications must meet one of the following Determination of Need Health Priorities:

  • Social environment
  • Built environment
  • Housing
  • Violence and Trauma
  • Employment
  • Education, or
  • Any other long-term care priorities identified by the Department of Public Health.

Comment Period

The Determination of Need Program will accept comments on the proposed Memorandum through October 19, 2020. Comments should be sent to

A copy of the proposed Memorandum can be found here


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